England's 34,000 family doctors will face Ofsted-style inspections overseen by a new chief inspector of general practice to secure "safe and responsive care", the health secretary, Jeremy Hunt, is to announce.
In March, Hunt welcomed findings of a government-commissioned review which proposed a fresh scrutiny regime and warned that there was "a clear gap in the provision of clearly presented, comprehensive and trusted information on the quality of care". Last year it was estimated that 10% of all GP practices posed a "significant risk" to patients – and would require physical inspections.
In a set of plans designed to underline the health secretary's pro-pensioner credentials, the health secretary will also say on Tuesday that every vulnerable elderly person will have a "named" NHS worker responsible for organising their heath and care needs. Keeping track of the myriad of care organisations and NHS appointments is a distressing experience and Hunt says older patients want to know who is responsible for their care.
A designated worker would help integrate health and social care as well as keeping the elderly out of hospital A&E wards, he says.
The ratings are likely to be run by the health watchdog the CQC, with which GP practices in England must register from 1 April, but overseen by a new chief inspector. Under an Ofsted-style plan the ratings, which will be published annually, would take into account safety, effectiveness and crucially patient experience. It is understood that this system will be in place before 2015.
The health secretary's intervention comes as a leading thinktank calls for a fresh debate over whether wealthy pensioners should receive universal benefits at a time when public funding for essential social care is drying up. The King's Fund warns that the government's attempts to cap social care costs for the elderly "won't solve the social care funding challenge".
It says that since 1980 the number of council residential care beds has dropped from 140,000 to just over 20,000 in 2012. At the same time there has been a dramatic increase in private care home places from 80,000 to 240,000. With NHS long-stay beds also cut by more than half to a little more than 15,000 this means social care for elderly people is largely "privatised".
How to pay for care, the King's Fund argues, is now an urgent public policy concern. Local authorities' spending will have fallen by £2.68bn by March 2014 – a cut of 20% over the current spending review period. The fund calls for a single budget for health and social care to respond to growing demands.
Liz Kendall, Labour's social care spokeswoman, has repeatedly said the government's reforms are being undone by a wave of cuts. "The government is in complete denial about the scale of the crisis that is now engulfing social care. We need a far bigger and bolder response to tackle this crisis and ensure a decent and fair system for the future," she said.
"The King's Fund is right to call for a single strategic budget for the NHS and social care – this is exactly what Labour has been calling for. We need a genuinely integrated care system which helps older people stay healthy and living independently in their own homes for as long as possible and which supports families to care for their loved ones."
Controversially the fund outlines radical solutions for making up the shortfall. The thinktank says a flat-rate charge of £20,000 on estates worth more than £40,000 could raise £4.8bn. Alternatively only giving winter fuel payment and free TV licences to those on pension credit raises £1.4bn.
"With just 9% of the total devoted to essential care needs … [this spending has] been subject to ever more draconian rationing, compared with the large sums of public money disbursed through universal benefits – such as winter fuel allowances, free TV licences and public transport – to all regardless of their needs, income or wealth," warns the fund.
On Monday night a Department of Health spokesperson said: "We recognise that the last spending review provided local government with a challenging settlement. But we prioritised adult social care by providing extra funding for local authorities to help maintain services. In order to make wider improvements to care and support, we need to fundamentally change the way that the system works, not just put in more money."
